Patient Lifetime Value (pLTV) — the true revenue horizon behind every ad rupee.

How it works.

Most healthcare founders under-count pLTV because they see only the first-visit invoice. The real revenue horizon includes four separate streams — the recall episode six months out, the second-family-member consultation, the cross-specialty referral inside the same group, and the referral loop back into acquisition itself. Ignoring any of them leaves money on the table and, more dangerously, leads to under-investment in acquisition because the ratio of pLTV to PAC looks worse than it actually is. A dental clinic that treats pLTV as Rs 2,500 will refuse a Rs 900 CPQL. The same clinic, measuring pLTV honestly at Rs 15,000 (recall, whitening, family referral, ortho cross-sell) will chase it happily.

1. Anchor the revenue event. Every billed visit from the PMS attributed to the patient's ID. No estimation. No proxy.
2. Join the recall retention curve. How many patients came back in month 6, month 12, month 24. Cohort-level, not average-level.
3. Attribute family referrals. Patients registered against the source-patient's referral field count into that patient's pLTV — this is the single biggest under-counted stream.
4. Attribute cross-specialty upsells. If the clinic runs multiple specialties, a dermatology-acquired patient converting to dental counts into the dermatology pLTV.
5. Discount for retention decay. Rupees five years out are worth less than rupees today. A simple 10-15% annual discount rate keeps pLTV honest.
6. Split by acquisition channel. A pLTV blended across paid, organic, and referral hides that referral patients typically have 1.4-1.8x higher pLTV than paid-acquired.

How ICG uses this.

pLTV is the anchor number for every ICG engagement's PAC target. Before the first ad rupee is spent, the ICG Dental Clinic Setup Calculator models pLTV from specialty mix, geography, and expected recall rate — the same model then decides what CPQL is defensible on Meta Catalyst IQ and what PAC the clinic can profitably absorb. For ICG-managed clinics, the pLTV curve is re-computed monthly against the actual cohort retention behaviour, not the launch-day assumption. Which is what closes the gap between marketing theory and clinic reality.

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